Laparoscopic surgery is a type of minimally invasive surgery. It is a substitute for traditional “open” surgeries and provides the benefits of minimizing post-operative pain, decreasing hospital stays and periods of disability, and reducing costs for both hospitals and patients.
Over 7.5 million laparoscopic surgeries are performed worldwide each year in the areas of, e.g., cholecystectomy, appendectomy, bariatric surgeries, gynecological surgeries, and urological surgeries. However, because of the incidence rate of port-site herniation for the laparoscopic surgeries, port-site closure is preferred for fascial incisions greater than or equal to 10 mm. Port-site closure can effectively reduce the rate of herniation, reducing the need for hernia repair surgery, which has estimated costs of between US$6,000-US$10,000 per procedure and three-week recovery times. Approximately 70% of the laparoscopic procedures performed have 10 mm or larger port-sites.
To ameliorate these problems, techniques for suturing the port site have been developed. Despite the benefits associated with the use of suture delivering devices, a number of challenges exist. Devices for port-site closure can rotate, tilt, and slide downward vertically in the wound track or incision during the insertion of a suture needle. If the device rotates, the suture will be deployed at less that the ideal 180 degree placement across the wound. If the device slides vertically during the insertion, the tissue bite of desired muscle/fascia layer is reduced for devices that use the peritoneum as a reference point for needle entry into the muscle/fascia layers. That is, if such a device is not engaged against the peritoneum due to downward sliding, the needle entry point into muscle/fascia layers will be lower than the intended position and reduce tissue bite. It is also desirable to provide a device configured to deploy the needles in a reproducible manner to minimize the amount of skill required from the operator. Accordingly, this disclosure is directed to systems and methods for wound closure that provide these and other desired characteristics.